The Patient Experience: Stereotype Threat in Medical Care

Abstract

Stereotype threat has significant potential to contribute to disparities in health and health care experience. Health care provider behavior can sometimes be perceived as endorsing group stereotypes. When a patient senses that they are being seen in terms of a group stereotype, stereotype threat may occur. Stereotype threat triggers a stress response that requires emotional regulation. The experience of stereotype threat causes increased vigilance for further evidence of discrimination or stereotyping. Both the physiologic and psychological effects of the stress response and vigilance can reduce a patient’s cognitive capacity, making it difficult to communicate effectively or to store new information. A patient may also withdraw from the encounter and further clinical guidance. Combined, this response is thought to contribute to poor post-encounter adherence, less trust, and delay of follow-up care. Health care providers can help patients protect themselves from stereotype threat by encouraging them to affirm values or recall accomplishments. Providers can also take steps to reduce the likelihood that implicit attitudes or stereotypes affect their behavior and prioritize creating a clinical environment that feels inclusive to all patients.